July 29, 2008 at 11:02 pm by Ian Kerr
Filed under Clinical Cases
This case highlights the point made in the last post about cost effective alternatives. The tooth in question had be scheduled for extraction and could only be replaced by an implant retained crown (approximately £2000) or a denture. A denture would be a problem in this case as there was active gum disease which is always harder to control in patients who where dentures. The tooth was too broken down for a routine crown.
At StoneRock we were able to offer an alternative option of a fibre reinforced composite to rebuild the tooth. This option is not only the cheapest and quickest option but it is the least invasive for the patient. (The cost of £275 is less than half the cost of it’s nearest rival). Clearly this is not a tooth for life and we will be faced with the loss of this tooth at some time, a fact the patient is fully aware of. If we can delay the loss of the tooth for 5-8 years then I believe we have done a great service to the patient and have allowed them time to plan their finances and, of course, allowed technology some time to improve and offer perhaps yet more alternatives.
As ever, if you would like to know more about this technique, or any other displayed, could help you then please do not hesitate to contact the surgery in the usual way01580 752202 info@stonerock.co.uk
July 29, 2008 at 10:50 pm by Ian Kerr
Filed under General, Dental Forum
Back in April 2007 I wrote that a decision to make endodontic files and reamers single use was going to spell the end of root canal fillings on the NHS. It is with sadness that I read yesterday that a government report on the new dental contract (introduced in April 2006) has seen a 45 % reduction in root canal fillings provided on the NHS. This has been matched by an increase in tooth extractions, a massive reduction in the number of crowns provided and an increase in the number of dentures provided.
Clearly this is not all due to the decision on endodontic files but the introduction of an extra cost of up to £45 per case for a treatment that the dentist receives £46 for is going to have an impact! (Interestingly the cost of endodontic files has gone up 25% in 2008 alone).
The government report provided a damming review of the new contract and predicted further deteriorations in the service if changes were not introduced. Unfortunately it is clear that the decision on how to treat a tooth is now, more than ever, based on strict financial conditions put upon the NHS dentist and these may not serve the patients best interests. Now if you hear that your tooth cannot be saved, perhaps you should ask “Can it not be saved at all? Or can it not be saved on the NHS in a way that the dentist can still earn a living and provide for his/her business/family/employees?”
July 29, 2008 at 9:39 am by Ian Kerr
Filed under General, Clinical Cases
I am back from two days lecturing in Norwich last week and am hugely motivated by the level of knowledge and dedication that the dentists we taught showed. I was lecturing as usual with Dr Jansie van Rensburg (www.fibrebond.co.uk) on our special interest in fibre reinforced composite restorations. I have mentioned this topic before in the blog and it is one of the exciting growth areas in dentistry. We taught a hands on course to 25 dentists over the two days and they all found the techniques easy to use and very beneficial for their patients.
A fibre reinforced composite restoration is a strengthened white filling that can provide an excellent restoration for a tooth that is too broken down for a normal filling but does not need (or the owner cannot afford) a crown. Following on from the previous post about alternative choices to amalgam fillings, this technique is ideally placed to allow patients to replace their current large amalgam fillings with out having to go the expense of multiple crowns. (A FRC costs approximately £275, typically, compared to £495 for a crown.)
If you would like to know more about FRCs and how they might help you then please do not hesitate to contact the practice on 01580 752202 or info@stonerock.co.uk
July 29, 2008 at 9:25 am by Ian Kerr
Filed under Behind the Headlines
The press have recently picked up on a change in attitude towards mercury fillings in the USA and, as ever, it has been poorly reported. The “change” that has taken place in the US Food and Drug Administration (FDA) which is now carrying out an “urgent” review and MAY consider banning amalgam fillings in the future. The concern relates to the possible neurotoxic effects on the nervous system of developing children and foetuses and is part of a 2 year review of current best knowledge. The findings were due in July 2008 so there may be some new evidence requiring interpretation. The decision is whether dental amalgam should be reclassified from a class 1medical device (which is subject to general controls only) or to a Class 2 device, which means it poses something of a risk and for which general controls are not enough to provide reasonable assurance of safety and effectiveness and, as such, must be subject to certain “special controls”. Clearly this is a long way short of an out right ban, but when did the British press let the facts get in the way of a good story?
The stance of the American Dental Association and British Dental Association remains the same that “amalgam fillings are a safe, durable and affordable cavity choice for dental patients that do not pose a health risk. (Sadly the BDA information is not for general viewing so I cannot share it with you - very disappointing)
At StoneRock our approach is, as ever, one of patient choice. For many years I have seen the demand for alternative filling choice rise almost exponentially and so provide very few amalgam fillings (less than one a month). My current understanding is that there is no proven health risk and in Britain alone 8 million amalgam fillings are placed annually with no evidence linking them to any specific disease or disorder. That said, I believe that decisions in these matters are far more emotional than scientific and if patients don’t feel comfortable having them then I will happily provide an alternative. (The same is true of every dentist within StoneRock.)
It is shame that such confusion exists over, what must be one of the most tested substances ever to be used in the human body but if any patient of StoneRock has concerns over their amalgam fillings please do not hesitate to contact the practice on 01580 752202 or info@stonerock.co.uk and we will be happy to help.
« Previous entries ·
Next entries »